Precontemplation
(Not changing in foreseeable future)

Goal for Intervention: Encourage and assist clients to learn more about their health and understand more about their particular health risks

Client Profile
Timeline: Client not intending to change behaviour in foreseeable future.

• pros for continuing behaviour outweigh cons
• awareness of risks may be incomplete, inaccurate or vague
• client may not believe the consequences are serious or will affect him/her
• client likely not thinking much about this lifestyle behaviour

 Intervention

• advise about your caring concern as a health professional
• use this opportunity to begin a supportive interaction
• increase awareness of particular risks
• encourage critical thinking about current behaviour including what is liked and not liked about it
• foster belief that people are able to change behaviours

• provide resource(s) (1,10,32)

Contemplation
(Intending to change in next 6 months)

Goal for Intervention: Assist clients to examine the pros and cons of changing and to have the confidence to try for change

Client Profile
Timeline: Client intending to change behaviour in the next 6 months.

• decisional balance changing - pros beginning to outweigh cons
• may lack confidence in ability to change
• looking for information

 Intervention

• provide information
• emphasize benefits of changing behaviour
• assist client to talk about reasons for wanting to change
• assist client to examine concerns and barriers to change
• gently offer possible solutions that have worked for others
• foster a positive belief in ability to change
• provide resource(s) (1,10,32)

Preparation
(Planning to change in next 4 weeks)

Goal for Intervention: Assist clients to replace one behaviour with another based upon personal experience.

Client Profile
Timeline:Client planning to take action in next 4 weeks.

• pros for changing behaviour outweigh the cons
• may have anxiety about failing to change or staying with it

Intervention

• assist client to verbalize a plan which includes a specific start date
• encourage client to consider family or peer support
• discuss what has worked and not worked in the past
• encourage client to avoid, change or remove cues that trigger the risk behaviour
• normalize relapse as part of the process – relapse is a learning experience
• focus on benefit most meaningful to client
• encourage client’s efforts
• provide resource(s) (1, 10, 32)

Action
(In the process of changing for less than 6 months)

Goal for Intervention: Assist clients to set and meet daily goals .

Client Profile
Timeline: Client is in the process of changing or has changed a behaviour in past 6 months.

• new behaviour being incorporated into lifestyle
• changes may be increasing stress levels
• concerns about relapse fluctuate

Intervention

• compliment client’s accomplishments and decision to change
• encourage client to reward self
• emphasize benefits
• encourage identification of what worked and plans to deal with temptations or barriers
• promote self-confidence
• normalize relapse as part of the process – relapse is a learning experience
• provide resource(s) (1,10,32)

Maintenance
(Has changed for 6 months or longer)

Goal for Intervention: Assist clients to retain the new behaviour.

Client Profile
Timeline: Client has maintained change from 6 months to 5 years.

• healthy behaviour incorporated into lifestyle
• enjoying benefits of healthier lifestyle

 Intervention

• support feelings of accomplishment
• encourage ongoing awareness of triggers and pitfalls
• emphasize the importance of continuing to reward self (1,10,32)

Relapse
(Risk behaviour resumed)

Goal for Intervention: Assist clients to see relapse as a normal part of the change process.

Client Profile
Timelines: Client has resumed risk behaviour and may be in precontemplation, contemplation or preparation.

• losing benefits of the healthier lifestyle
• disappointed in self or frustrated by barriers

Intervention

• normalize relapse as part of the process of change
• emphasize benefits that were gained
• identify and discuss reasons for relapse and counter strategies for next try
• reassess client’s current stage of change and intervene accordingly at next contact (1,10,32)